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1.
Radiol Case Rep ; 19(6): 2514-2519, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38585393

RESUMO

Spontaneous mesenteric hematomas (SMH) are not a common entity. Here we describe a case of 64 year old woman who presented with a vague abdominal pain and diffuse tenderness. Her CT abdomen revealed an ill-defined hyperdense mass like lesion in the mesentery and she underwent exploratory laparotomy which revealed a large hematoma in the mesentery with inflammation of the adjoining small bowel loop. Histopathology revealed findings consistent with hematoma with no evidence of neoplastic lesion.

2.
Georgian Med News ; (339): 117-122, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37522786

RESUMO

This study aims to characterize and contrast the triennial rates at which doctors prescribe PT, determine patient, doctor, and practicing characteristics related to every therapy suggestion, and assess pain relievers, lifestyle counseling, and PT as effective treatments for knee osteoarthritis (OA). We analyzed the National Ambulatory Medical Care Survey. Nonsteroidal anti-inflammatory drugs (NSAID), narcotics prescriptions, physical therapy referrals, and primary care physician visits for knee OA have been determined and evaluated. The average yearly rate after three years of therapy was determined. Using multivariable logistic modeling with adjustments for complicated sample design, we analyzed the relationships among patient, physician, and practice characteristics and treatments. Over time the patients were prescribed physical therapy to improve their lifestyle whereas the percentage of patients who were prescribed NSAIDs or drugs. Physical therapy, lifestyle therapy, and drugs were prescribed at similar rates across time for basic care doctor visits. There was an association between nonclinical characteristics and treatment suggestions, such as provider type, practice setting, and geographic proximity. Physical therapy (PT) and lifestyle counseling (LC) seem underused in patients with knee OA, but prescriptions for pain medication rose over the studied period. The treatment decisions varied due to variables outside of medicine. Increased usage of physical therapy and lifestyle changes, as well as decreased treatment variance for knee OA, are important areas for further study.


Assuntos
Osteoartrite do Joelho , Manejo da Dor , Humanos , Dor , Acetaminofen , Estilo de Vida , Anti-Inflamatórios não Esteroides/uso terapêutico , Osteoartrite do Joelho/tratamento farmacológico
4.
Asian J Psychiatr ; 39: 70-79, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30593987

RESUMO

BACKGROUND: We used two different yet complementary methods to capture the 'hidden population' of illicit substance users in the state of Punjab, India: Rapid Assessment Survey (RAS) and Punjab Drug Use Monitoring Survey (P-DUMS). METHODOLOGY: For the RAS component, following a pilot study, Respondent Driven Sampling was used to recruit 6600 community-dwelling substance dependent persons aged 11-60 years from all the 22 districts of Punjab. Size was estimated using benchmark-multiplier method, and prevalence was calculated by projecting these data to the source population. For the P-DUMS component, data were collected on 7421 inpatients from 75 government de-addiction centres from 19 districts of Punjab. RESULTS: Subjects In both RAS and P-DUMS were primarily opioid dependent (88% in RAS and 83% in P-DUMS). Heroin (inhaled/injected) emerged as the commonest opioid in both RAS (46%) and P-DUMS (52%), though 30.5% of the RAS sample also used the prescription opioid tramadol. Using the benchmark-multiplier method, 0.27 million (2.5% of the source population) were estimated to be opioid dependent, of which nearly 78,000 (0.7% of the source population) were injecting opioid users (IDUs), predominantly heroin (62%) but also buprenorphine (32.5%). High-risk behaviour was reported by nearly 60% of IDUs. Only 14% of the RAS sample had ever visited any de-addiction centre, and only 2.8% individuals had been admitted to a de-addiction centre in the past year. CONCLUSION: There is a substantive problem of opioid dependence in this difficult-to-reach population of Punjab, with low treatment access. Misuse of prescription opioids along with IDU also raises concern.


Assuntos
Drogas Ilícitas , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Psicotrópicos , Inquéritos e Questionários/estatística & dados numéricos , Adolescente , Adulto , Criança , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Prevalência , Adulto Jovem
5.
Asian J Psychiatr ; 32: 8-13, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29197711

RESUMO

BACKGROUND: Sleep disorders are frequently associated with psychiatric disorders and can be both cause and effect of the same. AIM: To study the prevalence of sleep disorders and the severity of insomnia in psychiatric outpatients. METHODS: 500 patients were randomly selected using purposive sampling from patients attending a tertiary level mental health care facility were evaluated for the presence of any sleep disorder along with their sleep quality. In patients having insomnia, severity of the same was determined. RESULTS: 83.4% of the population had some type of sleep disorder. Symptoms of insomnia were reported by 78.2% of the population and 29.2% had moderate to severe insomnia. 78.4% of the population had poor sleep quality. Significant difference was noted among the different psychiatric groups when insomnia severity index (ISI) was compared. In multinomial logistic regression, chance of severe insomnia is more if the diagnosis is depression, but less if mania or ocd, compared to psychosis. CONCLUSION: This study was the first in India to assess the prevalence of sleep disorders in psychiatric outpatients. Our study underscores the importance of careful evaluation of sleep problems for proper management of the patients.


Assuntos
Transtornos Mentais/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Transtornos do Sono-Vigília/epidemiologia , Adolescente , Adulto , Comorbidade , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Serviços de Saúde Mental , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Prevalência , Índice de Gravidade de Doença , Atenção Terciária à Saúde , Adulto Jovem
6.
Indian J Med Microbiol ; 35(2): 290-292, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28681824

RESUMO

The present study was conducted to understand the aetiological link between tuberculosis (TB) and sarcoidosis. Sera from smear-positive TB subjects (n = 24), smear-negative TB subjects (n = 24), sarcoidosis patients (n = 24) and healthy controls (n = 24) were collected and circulating immune complexes were isolated. Sandwich ELISA was performed for detecting four highly specific mycobacterial regions of difference (RD) proteins (early secretory antigenic target 6 [ESAT6], 10 KDa culture filtrate protein [CFP10], 21 KDa CFP [CFP21] and mycobacterial protein from species TB [MPT 64]). Sensitivity and specificity was calculated, and receiver operating characteristic plots were plotted. Non-parametric Mann-Whitney U-test was used to calculate statistical significance. Seventy per cent of sarcoidosis patients showed the presence of immune complexes of mycobacterial RD proteins similar to that observed in the sera of smear-negative TB patients as opposed to antibody-based detection assay based on these RD proteins. Thus, immunoassays based on specific mycobacterial RD proteins also need to be developed and validated carefully to differentiate TB and sarcoidosis, a close mimic of smear-negative tuberculosis.


Assuntos
Complexo Antígeno-Anticorpo/sangue , Mycobacterium tuberculosis/imunologia , Sarcoidose/patologia , Tuberculose Pulmonar/patologia , Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/sangue , Estudos de Casos e Controles , Voluntários Saudáveis , Humanos , Fatores Imunológicos/sangue
7.
J Assoc Physicians India ; 64(4): 91-92, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27734654

RESUMO

Coronary artery perforation (CAP) is a rare (0.43%) but scary complication of percutaneous coronary intervention with its associated morbidity and even mortality at times.It needs to be treated urgently either by percutaneous means or by open heart surgery, as the situation demands. In this report we are discussing a left anterior descending coronary (LAD) artery perforation sealed successfully using cyanoacrylate glue.


Assuntos
Adesivos/uso terapêutico , Vasos Coronários/lesões , Cianoacrilatos/uso terapêutico , Intervenção Coronária Percutânea/efeitos adversos , Angiografia Coronária , Doença da Artéria Coronariana , Humanos
8.
Indian Heart J ; 68 Suppl 2: S151-S152, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27751271

RESUMO

Hyperdominant left anterior descending artery (LAD) is a rare coronary anomaly in which posterior descending artery arises from LAD instead of left circumflex or right coronary artery. Here we present a case of hyperdominant LAD presenting as acute myocardial infarction.


Assuntos
Anomalias dos Vasos Coronários/diagnóstico , Vasos Coronários/diagnóstico por imagem , Infarto do Miocárdio/etiologia , Angiografia Coronária , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/cirurgia , Vasos Coronários/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/cirurgia , Intervenção Coronária Percutânea/métodos , Índice de Gravidade de Doença
9.
J Assoc Physicians India ; 64(6): 90-91, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27739281

RESUMO

Severe pulmonary stenosis presents early in life; late presentation is rare. Very late presentation like in our case is rarest of rare. Likewise calcification of pulmonary valve is rare. We describe here, one such case in an eighty-one year old female who astonishingly not only tolerated severe form of pulmonary stenosis but had also gone through three full term pregnancy, successfully without any untoward effect!


Assuntos
Valvuloplastia com Balão/métodos , Calcinose/complicações , Dispneia/etiologia , Estenose da Valva Pulmonar/terapia , Valva Pulmonar/anormalidades , Idoso de 80 Anos ou mais , Feminino , Humanos , Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/diagnóstico , Resultado do Tratamento
10.
J Assoc Physicians India ; 64(6): 93-94, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27739283

RESUMO

In the current era where percutaneous coronary interventions are increasingly performed day by day can device closure of congenital heart defects be far behind. We describe one unusual case of ventricular septal defect (VSD) in a child with absent inferior vena cava which was tackled in a novel way using hemiazygous vein as the conduit (access) to the right side of heart.


Assuntos
Comunicação Interventricular/diagnóstico , Intervenção Coronária Percutânea/métodos , Veia Cava Inferior/anormalidades , Criança , Ecocardiografia , Comunicação Interventricular/diagnóstico por imagem , Comunicação Interventricular/terapia , Humanos , Masculino , Veia Cava Inferior/diagnóstico por imagem
11.
12.
J Assoc Physicians India ; 64(5): 77, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27735159

RESUMO

Coronary cameral fistulae are rare and bicoronary pulmonary artery fistulae is even rarer. This is a case of a 70 year old male who presented to us with complaints of chest pain and dyspnoea. His ECG showed ST-T changes in inferior and anterior precordial leads suggestive of ischaemia in those territories. His coronary angiogram revealed bilateral coronary pulmonary arterial fistulae arising from left circumflex and right coronary artery and draining into pulmonary artery without any atherosclerotic narrowing of coronaries.


Assuntos
Fístula/diagnóstico por imagem , Artéria Pulmonar , Fístula Vascular/diagnóstico por imagem , Idoso , Dor no Peito/etiologia , Angiografia Coronária , Eletrocardiografia , Humanos , Masculino
14.
Med J Armed Forces India ; 71(2): 120-5, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25859072

RESUMO

BACKGROUND: Abnormal uterine bleeding (AUB) accounts for 33% of female patients referred to gynaecologists. Common causes of AUB include endometrial polyps, endometrial hyperplasia, submucous fibroids and anovulation. Accurate diagnosis of the cause of AUB can reduce the frequency of hysterectomy. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. METHODS: 100 female patients with AUB were enrolled in the study. Each patient was subjected to TVS where uterine cavity was studied in detail and hysteroscopy under anaesthesia using saline as distension medium. Sensitivity, specificity and predictive value of TVS as compared to hysteroscopy were calculated. Subgroup analysis within each group was also performed. RESULTS: Menorrhagia was the commonest presenting symptom in the study population (n = 58) followed by metrorrhagia, menometrorrhagia and continuous bleeding >21 days. 74 female patients had normal size uterus. In 57 patients, the uterine cavity was normal on TVS. Thickened endometrium, endometrial polyp and submucous fibroids were seen in 19, 16 and 6 patients respectively. Hysteroscopy showed normal cavity in 59 female patients and polypoidal endometrium, polyps or submucous fibroids in 41. TVS was found to have high sensitivity and specificity (95.23 and 94.82 respectively) and high positive and negative predictive value. Strength of agreement between TVS and hysteroscopy was high (kappa value 0.898). CONCLUSION: TVS is recommended as first line investigation in AUB. If TVS shows normal cavity, further evaluation can be omitted and patient started directly on medical treatment for her symptoms.

15.
J Assoc Physicians India ; 62(11): 48-50, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26281482

RESUMO

Complete heart block has a varied aetiology; commoner being ischaemia and senile degeneration of AV node. In this article we report a case of complete heart block (AV nodal) in patient of Kearns Sayre Syndrome who has incidently SA node disease also which is further rarer in this disorder.


Assuntos
Eletrocardiografia , Bloqueio Cardíaco/etiologia , Síndrome de Kearns-Sayre/complicações , Adolescente , Estimulação Cardíaca Artificial , Bloqueio Cardíaco/diagnóstico , Bloqueio Cardíaco/terapia , Humanos , Masculino
16.
J Assoc Physicians India ; 62(10): 68-70, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25906530

RESUMO

Coronary artery aneurysm after coronary interventions are rare but variable (0.2%-1.7%) clinicopathological entity depending on whether a incidental or a routine 6 monthly angiographic follow up finding and is seen more common with drug eluting stents (DES) rather than bare metal stents (BMS). It is of three types and depending on the type and patient clinical response further strategy (conservative, covered stents or coronary artery bypass surgery) is decided. We report a patient with large type 2 coronary artery aneurysms post percutaneous coronary intervention (PCI) to the right coronary artery (RCA) and the Left anterior descending (LAD) coronary artery and presenting four months later.


Assuntos
Angioplastia Coronária com Balão , Aneurisma Coronário/diagnóstico por imagem , Stents Farmacológicos , Complicações Pós-Operatórias/diagnóstico por imagem , Angiografia Coronária , Humanos , Imunossupressores , Masculino , Pessoa de Meia-Idade , Sirolimo
17.
Indian Heart J ; 65(5): 593-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24206883

RESUMO

OBJECTIVE: The e-BioMatrix is a post marketing multicenter registry with an objective to evaluate the 2 year clinical safety and efficacy outcomes in patients treated with BioMatrix™ - Biolimus A9™ (BA9™) drug eluting stents (DES). BACKGROUND: Drug-eluting stents still have late-stage disadvantages that might be attributable to the permanent polymer. BioMatrix a new generation DES containing anti-proliferative drug Biolimus A9™ incorporating a biodegradable abluminal coating that leaves a polymer-free stent after drug release enhancing strut coverage while preventing neointimal hyperplasia. METHODS: This interim analysis consists of a total of 1189 patients with 1418 lesions treated with BioMatrix stent who entered this multicenter registry in India. We analyzed the incidence of major adverse cardiac events (MACE) and stent thrombosis (ST) at 1, 6, and 12 months with an extended follow-up of 2 years. Recommended antiplatelet regimen included clopidogrel and aspirin for 12 months. RESULTS: The mean age was 57.6 ± 10.9 years, 81.8% were males, comorbidity index was 1.20 ± 1.33, 68% presented with acute coronary syndrome, 49% had hypertension and 40.8% had diabetes mellitus. One-year clinical follow-up was completed in 987 patients at the time of interim analysis. The incidence of MACE is 0.45 for 1544 person-year follow-up. There were only 03 cases of ST (01 late ST) reported during this time. CONCLUSION: This registry demonstrates excellent one-year clinical safety and efficacy of BioMatrix stents. The 1-year result shows that BioMatrix stent may be a suitable alternative as compared to contemporary DESs which are currently available in the market for simple as well complex disease.


Assuntos
Implantes Absorvíveis , Angioplastia Coronária com Balão/instrumentação , Estenose Coronária/terapia , Stents Farmacológicos , Sistema de Registros , Sirolimo/análogos & derivados , Síndrome Coronariana Aguda/epidemiologia , Fatores Etários , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/métodos , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/mortalidade , Feminino , Seguimentos , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Vigilância de Produtos Comercializados , Falha de Prótese , Radiografia , Medição de Risco , Fatores Sexuais , Sirolimo/farmacologia , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento
18.
Hum Exp Toxicol ; 32(6): 571-90, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23174745

RESUMO

Several experimental, pathological, epidemiological, and clinical studies have clearly depicted that diabetes mellitus results in cardiac functional and structural changes. Diabetic cardiomyopathy results in both structural and functional alterations in the myocardium. Several mechanisms have been implicated in the pathophysiology of diabetic cardiomyopathy. Of these, metabolic disturbances, myocardial fibrosis, small vessel disease, and cardiac autonomic neuropathy are the major players in the pathophysiology of diabetic cardiomyopathy. This review is intended to discuss various such pathophysiological mechanisms of diabetic cardiomyopathy. We have also described the systolic and diastolic dysfunctioning and its corelation to structural changes in diabetes.


Assuntos
Cardiomiopatias Diabéticas/fisiopatologia , Cardiomiopatias Diabéticas/metabolismo , Neuropatias Diabéticas/fisiopatologia , Ácidos Graxos não Esterificados/metabolismo , Regulação da Expressão Gênica , Humanos , Miocárdio/patologia
19.
Indian Heart J ; 65(6): 678-82, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24407537

RESUMO

New generation DES are effectively used in all spectrum of coronary artery diseases (CAD) and are replacing earlier DES and BMS. Biolimus A9™-eluting stent is a new generation DES containing the anti-proliferative drug biolimus A9™ incorporating a biodegradable abluminal coating that leaves a polymer-free stent after drug release enhancing strut coverage while preventing neointimal hyperplasia. A retrospective data analysis was done in patients treated with DES, with a major share of Biolimus A9™ (BA9™) drug-eluting stents (DES) at Bombay Hospital, Mumbai. A total of 158 patients with 219 lesions were treated with DES, comprising Biolimus A9-eluting stent and others and the major adverse cardiac events (MACE) rate and stent thrombosis (ST) at 1, 6, 12 months and 24 months were analyzed. Mace rate was 3.16% for average follow-up of 19 months. There were 3 cases of ST (2 of acute and 1 of subacute onset) and one non-cardiac death reported during this time. This retrospective data demonstrates good one- and two-year clinical safety and efficacy of DES, especially of BioMatrix stents in real world setting.


Assuntos
Implantes Absorvíveis , Causas de Morte , Estenose Coronária/mortalidade , Estenose Coronária/terapia , Stents Farmacológicos/efeitos adversos , Sirolimo/análogos & derivados , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Angioplastia Coronária com Balão/instrumentação , Angioplastia Coronária com Balão/métodos , Angioplastia Coronária com Balão/mortalidade , Angiografia Coronária/métodos , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/epidemiologia , Estenose Coronária/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/mortalidade , Polímeros/farmacologia , Desenho de Prótese , Falha de Prótese , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Sirolimo/farmacologia , Taxa de Sobrevida , Resultado do Tratamento , Adulto Jovem
20.
J Assoc Physicians India ; 61(12): 939-41, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24968561

RESUMO

Takatsubo cardiomyopathy is new emerging disease characterised by transient left ventricular systolic dysfunction followed by complete recovery of the same gradually over the course of few months. It represents 1-2% of all patients who present with acute ST elevation based on ECG finding and has a mortality of 1% and a recurrence of about 10%. The acute presentation greatly mimics acute coronary syndrome and needs differentiation from the same to avoid inadvertent thrombolysis and its consequences. We describe seven such patients at our institute over a period of 18 months.


Assuntos
Cardiomiopatias/complicações , Disfunção Ventricular Esquerda/etiologia , Dor no Peito/etiologia , Ecocardiografia , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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